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Original Article
Does the endotracheal tube insertion depth predicted by formulas in children have a good concordance with the ideal position observed by X-ray?
Rev Bras Ter Intensiva. 2020;32(2):295-300
Abstract
Original ArticleDoes the endotracheal tube insertion depth predicted by formulas in children have a good concordance with the ideal position observed by X-ray?
Rev Bras Ter Intensiva. 2020;32(2):295-300
DOI 10.5935/0103-507X.20200046
Views0ABSTRACT
Objective:
To evaluate the effectiveness of the different formulas for estimating the insertion depth of an endotracheal tube in children.
Methods:
This was an observational and cross-sectional study that included children between 29 days and 2 years of age who were hospitalized in a pediatric intensive care unit and mechanically ventilated. The formulas based on height [(height/10) + 5], the inner diameter of the tube (endotracheal tube × 3), and weight (weight + 6) were evaluated to determine which of them showed better concordance with the ideal insertion depth of the endotracheal tube as evaluated by X-ray.
Results:
The correlation between the height-based calculation and the ideal depth observed on X-ray was strong, with r = 0.88, p < 0.05, and a concordance correlation coefficient of 0.88; the correlation between the weight-based calculation and depth on X-ray was r = 0.75, p < 0.05, and concordance correlation coefficient 0.43; and the correlation between endotracheal tube diameter-based calculation and depth on X-ray was r = 0.80, p < 0.05, and concordance correlation coefficient 0.78. Lin’s concordance correlation analysis indicated that the measurements showed weak concordance (< 0.90).
Conclusion:
The formulas that estimate the insertion depth of the endotracheal tube in children were not accurate and were discordant with the gold-standard method of X-ray evaluation. There is a need for a new method based on anthropometric variables (weight and height) and age that is effective in guiding health professionals of pediatric intensive care units at the time of intubation.
Keywords:ChildInfantIntensive care units, pediatricIntubation, intratrachealThorax/imaging diagnosisSee more
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Case reports Child Coronavirus infections COVID-19 Critical care Critical illness Extracorporeal membrane oxygenation Infant, newborn Intensive care Intensive care units Intensive care units, pediatric mechanical ventilation Mortality Physical therapy modalities Prognosis Respiration, artificial Respiratory insufficiency risk factors SARS-CoV-2 Sepsis